The Awareness Center closed. We operated from April 30, 1999 - April 30, 2014. This site is being provided for educational & historical purposes.
We were the international Jewish Coalition Against Sexual Abuse/Assault (JCASA); and were dedicated to ending sexual violence in Jewish communities globally. We did our best to operate as the make a wish foundation for Jewish survivors of sex crimes. In the past we offered a clearinghouse of information, resources, support and advocacy.

Saturday, November 18, 1995

Dissociation: Nature's Tincture of Numbing and Forgetting

This is a historical article, written many years ago. Please note that The fields of memory are like a rich archeological site with layers
upon layer of artifacts from different periods, which through some
geological upheaval, got mixed up.

Some years ago my good friend Anastasia suffered a severe knee
injury in a bicycling accident. Facing emergency surgery with a
poor prognosis, she chose to forego general anesthesia in favor
of a spinal anesthetic with no sedative, so she could stay awake
to watch and ask questions. If nothing else, my friend told
herself, she could keep close watch over the delicate operation.
Anastasia remembers being lifted onto the surgical table and
getting the spinal injection. She also remembers the
anesthesiologist testing the soles of her feet with a needle
until she couldn't feel them anymore. But that's all. Next
thing she knew, she found herself "waking up" in the recovery
room, shocked and disappointed that she had "fallen asleep and
missed the surgery."

As she pondered her perplexing "sleep," the surgeon walked in and
enthusiastically thanked her for "a great discussion." He
commended Anastasia for her pinpoint curiosity and incisive
observations during the surgery, and he expressed his
astonishment at her "clinical" comments throughout the difficult
procedure. At first his praises puzzled Anastasia even more than
her puzzling "nap," but at last it dawned on Anastasia that she
must have carried on a technical discussion for nearly two hours,
a very long talk that she'd totally forgotten.

To this day, she remembers neither the discussion nor the
procedures she underwent during and immediately after the
surgery, though she has it on good authority that she remained
"conscious" throughout the operation. For over nineteen years,
this traumatic memory loss has perplexed Anastasia, otherwise
known for her practiced control, demanding self-discipline, and
sharp memory. She finds herself less puzzled by the fact she
suffered no post-surgical pain, despite an arduous
rehabilitation. Because of her training as a long-distance
runner and bicyclist, Anastasia knew then (and knows now) how to
block out pain and discomfort so she can "go the distance." To
shunt aside her stress during the surgical ordeal, to block her
pain, to compartmentalize her traumatic knowledge afterward,
Anastasia called upon an innate biological ability to dissociate,
an ability sharpened in her case by years of training and
competition.

We can't adequately explain this incident by the mechanism of
repression alone; instead, we must understand it as a compelling
example of dissociation, the dissociation of knowledge, emotion,
sensation, and memory. Dissociation refers to those
discontinuities of the brain, the disconnections of mind that we
all harbor without awareness. Take, for example, the feelings
from your feet. Until I brought them to mind, these feelings
most likely sparked and synapsed through some dim center in your
brain, some distant cubbyhole of your mind, far removed from your
conscious awareness. Now, pay no mind to your feet. Pay no mind
to the part of you that keeps track of time. Pay no mind to the
part of you that tends to your thirst. Pay no mind to the part
of you that carries your worst nightmare. Hard to do now? A
moment ago it wasn't.

Such is the way of dissociation. Dissociation lets us step
aside, split off from our own knowledge (ideas), our behavior,
emotions, and body sensations, our self-control, identity, and
memory. Dissociation, the splitting of mind and the
pigeon-holing of experience, is a natural adaptation to the
complex demands of daily life. Think back to the time when you
first learned to drive a car. At first, didn't you find driving
overwhelming, so greedy for your conscious attention? You had so
much to "pay mind to": the steering wheel, the turns in the
road, the gas pedal, the fog late at night, the clutch (or lack
thereof), the brakes, the rearview mirror, the other cars, the
road signs, the lions and tigers and bears. Oh my. In those
first early days, caught up in the act of driving itself, it must
have been hard to "keep in mind" that you actually meant to get
somewhere! But you did mean to get somewhere, so you did learn
to drive. Eventually.

Nowadays, you pretty much drive without really "minding" the
road. To do so, you had to learn to split off an auto-pilot who
could keep watch over all those things that once demanded your
"single-minded" attention. In effect, while driving you can go
to a land far far away, because you've got an auto-pilot who'll
shake you by the ears when it needs your conscious attention.

The most common form of dissociation involves spontaneous trance.
You may have heard it called "highway hypnosis," "spacing-out,"
"daydreaming," "lost in another world." By their very nature,
these trance states demand dissociation from aspects of on-going
experience.

Dissociation makes us all more resilient to life's daily
miseries. Who hasn't at some time or another "cracked up" or
"gone to pieces" or "numbed out?" Have you ever been "beside
yourself" or "out of your senses?" These idioms all refer to the
splitting off of aspects of consciousness. Greater loads of
traumatic stress create greater demands to dissociate.
Dissociation offers trauma victims the ability to blunt traumatic
realities. During the 1991 fires in the Oakland, California
hills, for example, homeowners with dissociative symptoms were
twice as likely as others to try to cross police barriers and
rush back into the flames (Goleman, 1994). Following the 1989
San Francisco Bay Area earthquake, Stanford researchers Cardena
and Spiegel (1993) found, among a sample of Bay Area graduate
students, a significant increase in the prevalence and severity
of transitory dissociative symptoms, including time distortion
and memory alterations.

I've experienced the practical value of dissociation in blunting
my own traumatic reality. Once I participated as the
hypnoanesthetist during major reconstructive surgery to the face
of one of my long-term clients. As I watched the surgeon
literally roll up my client's face toward her nose (after cutting
it free), I felt a sharp stab of abject terror, followed by
nausea and a weakening in the knees. Then came a massive shift
in my consciousness. Suddenly I grew quiet all over. All the
fear and dread snapped away. I could breathe and my vision
tunneled. I felt as though I were floating about an inch in
front of my body. In that instant, I gave my rapt, undivided,
and unselfconscious attention to the fascinating scene before me.

I remained in that dissociative, surreal state until well after
the surgery. As I walked to my car afterward, I played back the
surgical scenes again and again, without emotional reaction
except awe, until I got to my car and put the key in the door.
As I did so, my knees buckled, I wanted to vomit, and the color
drained out of my vision. Grabbing the door handle to support
myself, I took in the full load of the terror and revulsion I had
dissociated during the surgery. All the feelings and sensations
that would have overwhelmed me during the surgery came crashing
in from their temporary dissociative containers. I nearly passed
out on the spot.

During this surgery I made an adaptive choice to compartmentalize
my mind. Dissociation gave me the ability to stay present and
emotionally unreactive in my professional role during a traumatic
and demanding experience.

Of course I'm not alone in these experiences. In the summer of
1993, traumatic dissociation saved Donald Wyman's life. While
working in a remote Pennsylvania area clearing timber, Wyman
suffered a terrible accident. A huge tree fell on him, pinning
his left leg. He screamed for help for an hour, all the while
trying in vain to dig his leg out from under the huge tree. Then
Wyman made a decision. Because of the seriousness of his
injuries and the remoteness of the area, he knew that he would
die before anyone found him. So he made a tourniquet from a
rawhide bootlace and used his chainsaw wrench to tighten it.
Then, using a pocket knife, he set about methodically cutting off
his left leg about six inches below the knee. When he'd severed
the leg, he crawled to a bulldozer 500 feet away, drove it about
2,000 feet to his pickup truck, then drove the truck about two
miles to a farmhouse. The farmer, who called paramedics,
described Wyman as "sharp and mentally strong" (Pro, 1993).

Wyman remained conscious and kept his wits throughout the ordeal
because of his capacity to dissociate knowledge, body sensations,
and emotions. Had he truly been aware of the enormity of his
decision (knowledge), or felt the totality of the pain (body
sensations), or let terror overtake him (emotions), he would not
have survived. Instead, he summoned the truly remarkable human
capacity for dissociation.

For victims of sadistic and violent abuse, dissociation offers a
way to sanity and survival. Whether in bloody Bosnian back
rooms, Nazi death camps, or childhood holocausts in abusive
homes, victims use dissociation to escape intolerable terror and
pain, to cope with terrible loss. Because they're enjoined to
repress their suffering and dissent, victims of sadistically
abusive systems must split off these sentiments. Dissociation
allows the compartmentalization of experience, giving victims
relief from the stress of horrible secrets by putting them out
of consciousness. Victims of sadistic systems know that,
sometimes, it's best not to know the things they know. The
dissociation of knowledge gives victims the chance to manifest
"plausible deniability."

Elizabeth Loftus, PhD (ironically a member of the False Memory
Syndrome Foundation, Inc. Scientific Advisory Board, which
generally holds that people do not forget traumatic experiences)
described this very phenomenon in trauma victims as "motivated
forgetting" (1980, p. 71-73). She states that "forces seem to
operate to help people forget [traumatic experience], especially
when such forgetting would make life more bearable" (p. 82). To
illustrate this concept, Loftus cites several cases of airplane
crash survivors who forgot both their crashes and subsequent
rescues. She also discusses a case study (from Zimbardo & Rush,
1975) of a college professor who lost her memory traumatically:
It seems that she had suffered an incredible series of traumatic
events within the past year climaxing with the breakup of her
marriage and the sudden death of her mother before her eyes.
Amnesia put all that past ugliness, and more, out of awareness.
In its place this motivated forgetting had given her peace of
mind. (1980, p. 73) Though the woman dissociated her identity
and much of her memory, she held onto her professional knowledge
(English literature) "so that she was able to teach again even
before the rest of her memory returned" (Loftus, 1980, p. 72).
Over time, the patient pieced together the memories that had led
to her massive traumatic amnesia. With words seeming almost to
bless dissociation, Loftus quotes from Christina Rosetti's
Remember: "Better by far you should forget and smile than that
you should remember and be sad." This sentiment is a far cry
from the "false memory syndrome" hypothesis, which holds that
people "forget" a happy childhood in order to "remember"
terrifying "false" memories.

For victims of severe abuse, motivated forgetting (otherwise
known as dissociation) offers not only a means to cope, but also
the way to invisibility. Abuse victims are universally enjoined
not to show their pain, suffering, rage, and dissent. They must
learn to wall off and contain these reactions. "Crying, are you?
Well then, I'll give you something to really cry about."
Recounting his experiences while a prisoner in the Nazi
concentration camps at Dachau and Buchenwald (1938-1939), the
late psychoanalyst Bruno Bettelheim described the universal
injunction laid on prisoners by the Nazi camp guards: "Don't
dare come to my attention." Drawing parallels with the
traditional qualities of the "good" child, Bettelheim said that,
to the demand "to be seen and not heard (never talk back or
express an opinion) was . . . added the further injunction that
the prisoner . . . should also be unseen . . . . Invisibility
was thus a primary rule of defense" (1960, p. 210-211).

Of his own traumatic dissociation, Bettelheim (1960) wrote that a
"split was soon forced upon me, the split between the inner self
that might be able to retain its integrity, and the rest of the
personality that would have to submit and adjust for survival"
(pp. 126-127). In a passage clearly describing a dissociative
response, he states: Anything that had to do with present
hardships was so distressing that one wished to repress it, to
forget it. Only what was unrelated to present suffering was
emotionally neutral and could hence be remembered . . . . It was
not just coercion by others into helpless dependency; it was also
a clean splitting of the personality. (p. 197) Bettelheim
stressed that his reactions to varieties of events closer to
normal were "distinctly different from [these] reactions to
extreme experiences" (p. 129). He emphasized that these
reactions (amnesia, denial, emotional detachment, and so on)
emerged specifically as defenses to extreme traumatic events.

Arguably, the child's experience of abuse happening secretly
within their own family poses an even greater threat to
integration than that of the adult concentration camp prisoner.
At least (and this is a terrible reduction) the prisoners face
anonymous persecutors, and they're not altogether alone in their
horror. Such is not the case with children caught in a secret
horror. To function in daily life, children in acutely abusive
families may dissociate the knowledge of their on-going abusive
experience so they can hold onto an idealization of their
caregivers. Other demands also contribute to the dissociation of
knowledge. These include powerlessness, threats against
disclosure, injunctions not to trust personal perceptions,
attributions of fault laid on the victim, and the stigma of the
secret acts themselves.

Dissociation used as an acute means of coping with traumatic
stress is virtually synonymous with the hypnotic state. Soldiers
fight on, oblivious to their mortal wounds. A mother wholly
"forgets" her chronic arthritic pain as she dashes after her
child who has run into traffic. Sexually abused children often
report "leaving"their bodies when the pain of the assault became
unbearable. Chronically abused children learn to go into trance
to endure repeated acts of sexual aggression. Concentration camp
prisoners perform their daily grim labors by drifting in and out
of daydreaming, a state that Primo Levi (a survivor of the
Auschwitz concentration camp) called "the hypnosis of
interminable rhythm" (1959, p. 45). Farmers who lived within
earshot of the railroad tracks--which often carried people in
cattle cars to the Nazi death camps--learned to "forget to hear
the screams" coming from the boxcars, just to go on with daily
life.

Severe traumatic dissociation of knowledge is amnesia. A wealth
of studies have documented traumatic amnesia (partial and
complete) in victims of trauma, including survivors of combat,
natural and man-made disasters, violent crime, sexual assault,
torture, concentration camps, cults, child abuse, and vehicular
or industrial accidents. Winnie Smith, for example, a former
army nurse, says (1992) that she forgot, for 16 years, whole
segments of her traumatic experiences as a critical care nurse in
Vietnam.

At the farthest end of the dissociative continuum lies
dissociative identity disorder (DID, formerly MPD), with its
characteristic amnesia, derealization, depersonalization, and
personality-splitting. DID, an autohypnotic disorder, usually
comes into being to cope with prolonged traumatic childhood
demands (often sadistic abuse). Early, repetitive, sadistic
abuse overwhelms the child's unified personality and calls upon
the psyche to use massive dissociation and personality
compartmentalization. Massive dissociation typically occurs when
the traumatic experiences happen at a time when the child's brain
is still malleable to influences of any kind. The demands to
contain and manage the effects of massive trauma and paradoxical
realities ("I'm Daddy's favorite by day. By night Daddy likes to
hurt me.") may engender a compartmentalized, dissociative
structuring of consciousness.

People with DID may fragment traumatic memories into pieces that
are then held by unrelated personality fragments. One alter
personality, for example, may remember the events leading up to
abusive acts, another may remember participating in the
preliminary activities, and others may carry the actual
sensations and knowledge of the assault. For trauma victims,
visual memory sometimes takes leave of kinesthetic memory, as
when the abuse victim "floats" above her body. Likewise,
auditory memories may be cleaved and disowned, only to return
later as the haunting sound of intrusive voices. Without
therapy, these fragments usually remain disintegrated. This
compartmentalization serves many purposes. Most important, it
allows abuse victims to bear unbearable experiences. Without a
strong demand for integration, personality fragmentation can
continue for a lifetime. The fragments of the traumatic
storyline gradually coalesce as the patient gathers sufficient
ego strength to contain and work through them, a process usually
occurring only with therapy.

The alters in a system often hold incredible dissociative
strength. Even under oath, alters without knowledge of
particular events will testify "truthfully" that the events never
happened. They'll even pass a polygraph test. At the same time,
other alters in the system will testify "truthfully" that the
events did indeed happen. This dissociative strength
characterizes the victim as well as the victimizer. Sex
offenders with dissociative disorders may spontaneously
dissociate sexual offenses (Bliss & Larson, 1985; Ondrovik &
Hamilton, 1991; Schwartz, 1992; Stamatiou, 1994).

Out of sight, though, is not out of mind, but in "parallel mind."
Sometimes dissociated traumatic experiences "leak" across
dissociative barriers. Old feelings and body sensations may
intrude on present-day experience. Clinically, present day
anxiety or panic disorders often turn out to be unexpressed
affects from earlier traumatic events that leak from their
dissociative container to affect present emotions and behavior.
For a rape victim, a whiff of the wrong aftershave in an elevator
triggers pervasive panic and dread. A WW II psychiatrist noted
that bombing raid convalescents scanned the sky and "became upset
by the sight of a harmless sparrow" (Mira, 1943, p. 102).

Dissociated, unmetabolized body sensations of sadistic abuse may
leak into the present as physical flashbacks, sometimes called
body memories. Especially with survivors of sadistic sexual
abuse, we often find that body sensations return before other
memories, and leaking panic may permeate the therapy process for
years before the clients consciously recall the abuse. I once
treated an adult client working through a decade-long amnesia for
a prolonged, brutal, multiple-perpetrator sexual assault in which
she'd been left for dead. She often bled vaginally, though not
in session. In one particularly intense therapy session,
however, this client suffered a severe vaginal hemorrhage. The
heavy flow of blood quickly became visible, understandably
alarming both of us, so I took the client to a nearby hospital
emergency room.

Following her examination and treatment, which included
cauterization to stop the bleeding, the hospital staff called in
a rape investigation team. The client, however, adamantly
refused to give them a statement, insisting that she had nothing
to report; to her mind, and in reality, the rape had occurred
many years ago, and she didn't want to discuss it. The rape
investigation team replied that, while they understood her
reluctance to report the rape, they insisted that my client had
indeed suffered a recent rape. They offered as proof the
physician's report that the client's tissue wounds were "about
three days old." Though it took a long time, this client at last
worked through these traumatic memories. When she had fully
metabolized the rape experience, her chronic vaginal bleeding
stopped.

Early in his career, Sigmund Freud recognized dissociation as a
fundamental clinical mechanism in his hysterical patients
reporting childhood sexual abuse. He wrote that "the splitting
of consciousness . . . exists rudimentarily in every hysteria,"
and he considered "the tendency to this dissociation [to be] the
chief phenomena of this neurosis" (1936, p.8). By 1897, though,
Freud stopped believing his patients when they described
childhood sexual trauma. About the same time, he also abandoned
the dissociative framework, and along with it hypnosis, its
primary investigative tool. Freud subsumed dissociative
phenomena under his new concept of repression, the central
psychoanalytic tenet that people tend to inhibit (and
consequently tend not to remember) unacceptable wishes, impulses,
affects, and especially unacceptable sexual impulses.

We mistake ourselves when we call the dissociation of a traumatic
experience "repression," and we do our clients a disservice when
we insist that their late recollection of abusive experiences
involves intact memories filtering up from the depths of
unconsciousness. Quite often these recollections point to a
leakage, a breaking-down of the walls built around memory
fragments. "Repressed" memories may not be repressed at all. We
must learn to distinguish between not remembering (simple
forgetting), burying intact memories (repression), and never
consciously knowing the whole of a memory (traumatic
dissociation).

Dissociation not only helps manage the painful realities of abuse
victims, but also the split realities in abusive family systems.
In such systems, family members often use dissociation to
compartmentalize experience. They may isolate important
incidents, for example, often failing to see any pattern
connecting them. Mothers in incestuous families tell belatedly
they didn't relate suspicious incidents to one another, thus
diluting their cumulative meaning. Other members may use
dissociation to live in parallel realities: One father with an
alcoholic wife bitterly complained that his adult daughter hadn't
known what it had been like to live with an alcoholic woman. In
making this complaint, the father "forgot" that the daughter had
been the primary caretaker of the often drunk mother.

Memories of shattering childhood events seldom "bubble up"
intact. Instead, they live in the apartment next door, they bang
on the pipes and shout at you at night, and sometimes they come
crashing through the walls to grab at life. Memory work for most
trauma survivors means becoming best friends with the worst
neighbors imaginable.

Traumatic dissociation gave my friend Anastasia a way to put
aside her knowledge, emotions, and sensations of a traumatic
event. It gave her a purely clinical autopilot to deal with her
situation, as her surgeon will attest. A practiced athletic
faculty to dissociate allowed her to block out pain throughout a
rigorous rehabilitation to a full recovery. She still runs
marathons.

Anastasia's long-term dissociative amnesia doesn't threaten us,
so no one will cry "false memory" or start a foundation if she
ever regains her memory. But looking back with her to that
bloody event, we see that memory is merciful. Traumatic
dissociation, the tincture of numbing and forgetting, let's us
detach from traumatic suffering until the day comes when we're
strong enough to feel again and say, I remember.

References

Bettelheim, B. (1960). The informed heart: A study of the
psychological consequences of living under extreme fear and
terror. London: Penguin Books.

Ondrovik, J., & Hamilton, D. (1991). Sexual perpetrators: Rule
out dissociative disorders. Paper presented at the Second
International Conference for the Assessment and Treatment of Sex
Offenders, University of Minnesota, Minneapolis, MN.

Subscribe to The Awareness Center's Newsletter

Translate

Survivors ARE Heroes!

The Awareness Center believes ALL survivors of sex crimes should be given yellow ribbons to wear proudly.

Survivors of sexual violence (as adults and/or as a child) are just as deserving of a yellow ribbon as the men and women of our armed forces, who have been held captive as hostages or prisoners of war.

Survivors of sexual violence have been forced to learn how to survive, being held captive not by foreigners, but mostly by their own family members, teachers, camp counselors, coaches babysitters, rabbis, cantors or other trusted authority figures.

For these reasons ALL survivors of sexual violence should be seen as heroes!